Microbicide: Prevention from HIV and Other STDs

The danger of the HIV and STDs to people’s health and life has led scientists do research more about the prevention that can protect them from the infections. Tendency to do research for the prevention than the treatment happens because the infections are able to kill people. Logically, it will be easier and better to prevent than cure. The prevention will help more than treatment.

Microbicide is one of the inventions for the prevention of HIV and other kinds of STD. The compounds or the substances of the microbicide will help to reduce the infection possibility from virus, bacterium, fungus, and any kind of microorganism. Topical microbicide can be used in the condom or in the genital organs directly. It is applied to prevent the infection to transmit.

The method of the prevention is getting easier to be done. The microbicide helps people to protect themselves from HIV and STD simpler. However, the method which is published is quite political. Then, microbicide can be the break of the political prevention of HIV and STDs. This can be controversial, but, it can be suitable or even better in certain kind of situation.

Microbicide for women will very useful. The chance of the infection of HIV and STD for women is quite high through sexual contact. Women sometimes do not have control to make the men use condom for the safe sex. Then, it will be better for women to use microbicide which can prevention infection of HIV and other STDs. From all the explanations of the use of microbicide, that the microbicide will decrease the number of the infected people.

Microbicide & HIV

Finding a protection from HIV is needed by people. WHO (World Health Organization) says that microbicide can protect people against HIV and other sexual transmitted diseases. Microbide itself are compounds. The compounds are used inside of the vagina or rectum. The compounds which formed in gel, cream, films, or suppositories are able to decrease the risk of the disease’s transmission.

Using Microbicides become important for people to prevent the infection of STD especially HIV. It becomes the other way for the method in preventing HIV, instead of using condom. The microbicide will help women to involve in the prevention. The prevention will be not only depended on men. Women can take control to prevent them to be infected.

Microbicide & Safe Sex (11)

Pubic Lice

Pubic Lice also called crab lice or "crabs," pubic lice are parasitic insects found primarily in the pubic or genital area of humans. Pubic lice infestation is found worldwide and occurs in all races, ethnic groups, and levels of society.

Pubic lice usually are found in the genital area on pubic hair; but they may occasionally be found on other coarse body hair, such as hair on the legs, armpits, mustache, beard, eyebrows, or eyelashes. Pubic lice on the eyebrows or eyelashes of children may be a sign of sexual exposure or abuse.

Pubic lice have forms: the egg (also called a nit), the nymph, and the adult.

Nit: Nits are lice eggs. They can be hard to see and are found firmly attached to the hair shaft. They are oval and usually yellow to white. Pubic lice nits take about 6-10 days to hatch.

Nymph: The nymph is an immature louse that hatches from the nit (egg). A nymph looks like an adult pubic louse but it is smaller. Pubic lice nymphs take about 2-3 weeks after hatching to mature into adults capable of reproducing. To live, a nymph must feed on blood.

Adult: The adult pubic louse resembles a miniature crab when viewed through a strong magnifying glass. Pubic lice have six legs; their two front legs are very large and look like the pincher claws of a crab. This is how they got the nickname "crabs." Pubic lice are tan to grayish-white in color. Females lay nits and are usually larger than males. To live, lice must feed on blood. If the louse falls off a person, it dies within 1-2 days.

Microbicide &Safe Sex (10)

PID

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It usually occurs when sexually transmitted bacteria spread from your vagina to your uterus and upper genital tract. Many women who develop pelvic inflammatory disease either experience no signs or symptoms or don't seek treatment. Pelvic inflammatory disease may be detected only later when you have trouble getting pregnant or if you develop chronic pelvic pain.

Symptoms in PID range from subclinical (asymptomatic) to severe. If there are symptoms, then fever, cervical motion tenderness, lower abdominal pain, new or different discharge, painful intercourse, or irregular menstrual bleeding may be noted. It is important to note that even asymptomatic PID can and does cause serious harm. Laparoscopic identification is helpful in diagnosing tubal disease, 65–90% positive predictive value in patients with presumed PID. Regular Sexually Transmitted Infection (STI) testing is important for prevention. Treatment is usually started empirically because of the serious complications that may result from delayed treatment. Definitive criteria include: histopathologic evidence of endometritis, thickened filled fallopian tubes, or laparoscopic findings. Gram-stain/smear becomes important in identification of rare and possibly more serious organisms.

A woman can get PID if bacteria (germs) move up from her vagina and infect her pelvic organs. Many different types of bacteria can cause PID. But, most cases of PID are caused by bacteria that cause 2 common sexually transmitted infections (STIs) — gonorrhea and chlamydia. It can take from a few days to a few months for an infection to travel up from the vagina to the pelvic organs.

You can get PID without having an STI. Normal bacteria found in the vagina and on the cervix can sometimes cause PID. No one is sure why this happens. You can get pelvic inflammatory disease without having an STI. Normal bacteria found in the vagina and on the cervix can sometimes cause pelvic inflammatory disease. No one is sure why this happens.

Microbicide & Safe Sex (9)

HPV

Human papillomavirus or HPV, is the name for a group of viruses that includes more than 100 types. More than 40 types of HPV can be passed through sexual contact.

The types of HPV that infect the genital area are called genital HPV. Over half of sexually active people will have HPV at some point in their lives. But most people never know it. This is because HPV most often has no symptoms and goes away on its own.

HPV is passed on through genital contact, most often during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.

A person can have HPV even if years have passed since he or she had sexual contact with an infected person. Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner. It is also possible to get more than one type of HPV. Very rarely, a pregnant woman with genital HPV can pass HPV to her baby during delivery. In these cases, the child can develop Recurrent Respiratory Papillomatosis (RRP), a rare condition in which warts grow in the throat. In children, this is also referred to as juvenile-onset Recurrent Respiratory Papillomatosis (JORRP).

Microbicide & Safe Sex (8)

HIV/Aids
Persons initially infected with HIV may develop an "acute retroviral syndrome" characterized by fever, lymph node enlargement, and flu-like symptoms. If symptoms are present, they clear spontaneously, but all infected persons, both with and without symptoms, remain infected and infectious to others indefinitely. The incubation period is highly variable, averaging about a decade, but ranging from a few months or years to possibly longer than two decades. When sufficient damage to the immune system has been sustained, measured either by laboratory cell counts of the Thelper cells or by onset of opportunistic infections, the patient is said to have AIDS. Common manifestations of HIV infection include tiredness, lymph node enlargement, fever, weight loss, and yeast infections of the mouth and vagina.

HIV infection is diagnosed by laboratory detection of evidence of infection, usually identification of HIV-specific antibodies in a blood, oral fluid, or urine specimen. AIDS can be diagnosed in HIV-infected persons in several ways, based on either laboratory evidence of immunodeficiency (lowered levels of CD4+ cells), or clinically by onset of any one or more of a specific list of opportunistic diseases. Opportunistic diseases are those that occur only, or most severely, in patients whose immune systems are impaired. The most common opportunistic diseases in AIDS patients are Pneumocystis carinii pneumonia, Kaposi's sarcoma, toxoplasmosis of the brain, tuberculosis and other mycobacterial infections, and severe herpes, cytomegalo virus, and yeast infections.

How the AIDS Virus Works?
The AIDS virus weakens the immune system (“immune deficiency”), allowing other infections to ravage the body. These infections are called “opportunistic” because they take advantage of the opportunity to live where the body’s immune system would normally destroy them. It’s when these opportunistic infections strike that the person is said to have AIDS.

Microbocode & Safe Sex (7)

Genital Herpes

Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). Most genital herpes is caused by HSV-2. HSV-1 can cause genital herpes. But it more commonly causes infections of the mouth and lips, called “fever blisters.”

Most people have no or few symptoms from herpes infection. When symptoms do occur, they usually appear as 1 or more blisters on or around the genitals or rectum. The blisters break, leaving tender sores that may take up to 4 weeks to heal. Another outbreak can appear weeks or months later. But it almost always is less severe and shorter than the first outbreak.
Although the infection can stay in the body forever, the outbreaks tend to become less severe and occur less often over time. You can pass genital herpes to someone else even when you have no symptoms.

You can get genital herpes through genital-genital contact or genital-oral contact with someone who has herpes infection. The virus is most easily spread through contact with open sores. But you also can get the virus from skin that does not appear to have a sore. You can become infected with the herpes virus without having intercourse.

Symptoms of herpes outbreaks typically begin with pain, tenderness, or itching in the genital area and may also include fever and headache. Bumps and blisters may appear on the vagina, penis, scrotum, anus, thigh, or buttocks. Blisters soon open to form painful sores that can last up to 3 weeks.

Microbicide & Safe Sex (6)

Hepatitis B

Hepatitis B is a virus that infects the liver. Most adults who get hepatitis B have it for a short time and then get better. This is called acute hepatitis B.
You can have hepatitis B and not know it. You may not have symptoms. If you do, they can make you feel like you have the flu. But as long as you have the virus, you can spread it to others.
Sometimes the virus causes a long-term infection, called chronic hepatitis B. Over time, it can damage your liver. Babies and young children infected with the virus are more likely to get chronic hepatitis B.

Hepatitis B is caused by the hepatitis B virus. It is spread through contact with the blood and body fluids of an infected person.
You may get hepatitis B if you:
==> Have sex with an infected person without using a condom.
==> Share needles (used for injecting drugs) with an infected person.
==> Get a tattoo or piercing with tools that were not cleaned well.
==> Share personal items like razors or toothbrushes with an infected person.
==> A mother who has the virus can pass it to her baby during delivery. If you are pregnant and think you may have been exposed to hepatitis B, get tested. If you have the virus, your baby can get shots to help prevent infection with the virus.
You cannot get hepatitis B from casual contact such as hugging, kissing, sneezing, coughing, or sharing food or drinks.

Many people with hepatitis B do not know they have it, because they do not have symptoms. If you do have symptoms, you may just feel like you have the flu. Symptoms include:
# Feeling very tired.
# Mild fever.
# Headache.
# Not wanting to eat.
# Feeling sick to your stomach or vomiting.
# Belly pain.
# Diarrhea or constipation.
# Muscle aches and joint pain.
# Skin rash.
# Yellowish eyes and skin (jaundice). Jaundice usually appears only after other symptoms have started to go away.
Most people with chronic hepatitis B have no symptoms.

A simple blood test can tell your  if you have the hepatitis B virus now.
The Home Bio Hepatitis B test is an easy to use, accurate and reliable assay that will detect antibodies to the hepatitis B virus present in whole blood, serum or plasma.
The test is easy to use and the result is available within minutes – in the privacy of your own home.
Our test kits are the same as those used by doctors and other healthcare professionals to screen for infection with hepatitis. The test is specific for hepatitis B and has an accuracy greater than 99.8%.
You simply prick your finger, using the lancet provided, and transfer a few drops of your blood to the test cassette with the dropper provided. The easy to read result will develop after ten minutes and you will learn your hepatitis B status.

Microbicide & Safe Sex (5)

STD Gonorrhea Information
Gonorrhea sometimes mistaken for the clap (Chlamydia) isn't really an STD (Sexually Transmitted Disease) but actually an STI (Sexually Transmitted Infection). It's caused by bacteria called Neisseria gonorrhoeae which lives in the sexual organs including the urethra and reproductive tracks of both men and women.
Gonorrhea has one of the highest infection rates. In the USA It's estimated that almost one million people a year are infected with this STD. The most effected are young adults and teens mostly because of there high promiscuity rate between them.
Like most STDs and STDs it is contracted through sexual contact. Including coming in contact with the penis, vagina, anus, and even the mouth and throat. It is very easily transmitted from one person to another, which is why Gonorrhea has such a high rate of infection. On top of that the new strains of Gonorrhea are becoming increasingly harder to treat as they are adapting to the antibiotics used to treat them.

Gonorrhea Symptoms Do I Have Gonorrhea?
Gonorrhea symptoms are generally mild to non existent. When there are symptoms of Gonorrhea they will usually become noticeable between 5 and 30 days and differ slightly between men and women. Since gonorrhea lives in the sexual organs and in the throat these are the primary places to be aware of when wondering if you have gonorrhea symptoms.

Microbicide & Safe Sex (4)

Genital Warts

Genital warts (or Condylomata acuminata, venereal warts, anal warts and anogenital warts) is a highly contagious sexually transmitted disease caused by some sub-types of human papillomavirus (HPV).
Genital warts are flesh-colored or gray growths found in the genital area and anal region in both men and women.

It is spread through direct skin-to-skin contact during oral, genital, or anal sex with an infected partner.
Genital warts affect both men and women and can occur at any age.
Most patients with genital warts are between the ages of 17-33 years. Genital warts are highly contagious. There is around a 60% risk of getting the infection from a single sexual contact with someone who has genital warts.

Whilst of those infected with genital HPV it is estimated that only a "small percentage" (between 1% and 5%) develop genital warts, those infected can still transmit the virus. Other types of HPV also cause cervical cancer and probably most anal cancers, however it is important to underline that the types of HPV that cause the overwhelming majority of genital warts are not the same as those that can potentially increase the risk of genital or anal cancer.

Although genital warts are painless, they may be bothersome because of their location, size, or due to itching.

You can’t get genital warts from hugging, sharing baths or towels, from swimming pools, toilet seats, cups or cutlery.

Symptoms
Genital warts are usually painless and do not pose a serious threat to a person’s health. However, they can appear unsightly and cause psychological distress.

Microbicide & Safe Sex (3)

Chlamydia
Click here to learn about Chlamydia and click here to learn about Chlamydia Home Test.

Cytomegalovirus (CMV)

Cytomegalovirus (CMV) is a common virus.
CMV is part of the herpes family of viruses. As with most other herpes-type viruses, once you are infected with CMV, it will remain inactive in your body for the rest of your life. CMV causes few symptoms in most people.

CMV is spread through bodily fluids, such as saliva and urine. It can be passed on through close bodily contact. For example, the infection can be found in small droplets of saliva which are spread from one person to another when an infected person coughs or sneezes.

Unlike many viral infections, CMV usually causes few if any symptoms. Most people do not know they have (acquired) an infection.

The symptoms of cytomegalovirus (CMV) differ depending on whether you have:
- primary CMV - where someone develops a CMV infection for the first time
- re-infection with CMV - an infection with a different strain of virus
- reoccurring CMV - a previously inactive CMV infection is reactivated, often because the immune system (the body’s natural defence against infection and illness) is weakened
- congenital CMV - a CMV infection develops when a woman is pregnant and infects the unborn baby

Primary CMV
Most cases of primary CMV cause no noticeable symptoms. If you do experience symptoms, they will be similar to flu symptoms and can include:
- a high temperature of 38C (100.4F) or above
- extreme tiredness
- sore throat
- swollen glands
- muscle and joint pain
- loss of appetite

These symptoms should only last for a couple of weeks.

Microbicide & Safe Sex (2)

STD Risk of unsafe sex
Vaginal or anal intercourse without a condom and/or microbicide — high risk for passing:
- chancroid
- chlamydia
- cytomegalovirus (CMV)
- genital warts
- gonorrhea
- hepatitis B
- herpes
- human immunodeficiency virus (HIV)
- human papilloma virus (HPV)
- pelvic inflammatory disease (PID)
- pubic lice
- scabies
- syphilis
- trichomoniasis

Oral sex without a condom — High risk for passing:
- CMV
- gonorrhea
- hepatitis B
- herpes
- syphilis

Microbicide & Safe Sex (1)

In this first decade of the 21st century the various risks connected with having sex have (alas) increased.
The figures for HIV, chlamydia and gonorrhoea are all going up. This is almost entirely because so many people – whether they're heterosexuals or homosexuals or 'bi' – don't practise safe sex.

One way to have safer sex is to only have one partner who has no sexually transmitted infections and no other partners than you.

But, this isn't always the safest kind of safer sex. That's because most people don't know when they have infections. They are very likely to pass them on without knowing it.

Another other reason is that some people aren't as honest as they should be. In fact, about 1 out of 3 people will say they don't have an infection when they know they do, just to have sex. So most of us have to find other ways to practice safer sex.

Another way to practice safer sex is to only have sex play that has no risk — or a lower risk — of passing STDs. This means no vaginal or anal intercourse. Many of us find that great sex is about a lot more than a penis going in a vagina or anus. It is about exploring the many other ways you and your partner can turn each other on. Not only is it a way to discover new sexual pleasures, it's also safer.

Safe Sex:
- Reduces our risk of getting a sexually transmitted disease (STD)
- Using condoms and/or microbicide makes vaginal or anal intercourse safer sex
Although condoms provide the best form of protection for people who are sexually active, using a microbicide will be much safer than nothing for women for whom condom use is unlikely or impossible.

For some women and men, the contraceptive effect of condoms is a major deterrent to use; developing both contraceptive and non-contraceptive microbicides is important. Providers can counsel patients on the use of microbicides in conjunction with condoms for added protection, and as a "backup" method when condom use cannot or does not occur.

Microbicide Delivery system

The past decade has seen several effective anti-HIV-1 agent discoveries, yet microbicides continue to disappoint clinically. Our review expounds the view that unsatisfactory microbicide failures may be a result of inefficient delivery systems employed.

Microbicide delivery devices will be critical in ensuring safe and effective use of microbicide products. The device impacts the product’s overall safety (relationship with product purity and stability, avoidance of local trauma associated with insertion or use), efficacy (consistent delivery of the required amount of product in the intended location), and acceptability (comfort, ease of use, disposability).

Several novel microbicide delivery methods to help reduce cost, ensure microbicide efficacy, and increase user acceptability. Methods include:
• Diaphragm:  This combination of barrier method and microbicide could enable prevention of both pregnancy and disease. Two studies were recently completed. One study assessed gel retention and distribution in the vagina comparing Diaphragm single-sided and double-sided gel delivery to a
vaginal applicator. The second study used the same three gel application modes and evaluated couples’ use acceptability.
• Paper applicator with dosage stop: This user-filled applicator is low cost, easily disposed of, and prevents over-filling, making it an important option for microbicide gel delivery in low-resource settings.
• Rectal applicator: This applicator has been designed specifically for the rectal delivery of microbicide products.

Intravaginal targeting of HIV-1 increases the chances of microbicide success, wherein vaginal micro environmental factors including pH should be maintained at HIV-1 prohibitive acidic levels simultaneously to ward off other sexually transmitted diseases, which compromise vaginal epithelial barrier properties.

Furthermore, choice of receptors to target both on HIV-1 and on target cells is vital in deterring transmission. Appropriate modeling of virus–target cell interactions as well as targeting early stages of the HIV-1 infection accompanied by computation and delivery of appropriate microbicide quantities could revolutionize microbicide research, ultimately delivering a female-controlled HIV-1 prevention modality appropriately.
(Qualitative and quantitative intravaginal targeting: Key to anti-HIV-1 microbicide delivery from test tube to In Vivo success; Viness Pillay,*, Felix Mashingaidze, Yahya E. Choonara, Lisa C. Du Toit, Eckhart Buchmann, Vinesh Maharaj, Valence M. K. Ndesendo, Pradeep Kumar)

More about Microbicides

Microbicides for sexually transmitted diseases are pharmacologic agents and chemical substances that are capable of killing or destroying certain microorganisms that commonly cause human infection (for example, the human immunodeficiency virus).

Microbicides are a diverse group of chemical compounds that exert their activity by a variety of different mechanisms of action. Multiple compounds are being developed and tested for their microbicidal activity in clinical trials. Microbicides can be formulated in various delivery systems including gels, creams, lotions, aerosol sprays, tablets or films (which must be used near the time of sexual intercourse) and sponges and vaginal rings (or other devices that release the active ingredient(s) over a longer period). Some of these agents are being developed for vaginal application, and for rectal use by those engaging in anal sex.

Although there are many approaches to preventing sexually-transmitted diseases in general (and HIV in particular), current methods have not been sufficient to halt the spread of these diseases (particularly among women and people in less-developed nations. Sexual abstinence is not a realistic option for women who want to bear children, or who are at risk of sexual violence. In such situations, the use of microbicides could offer both primary protection (in the absence of condoms) and secondary protection (if a condom breaks or slips off during intercourse). It is hoped that microbicides may be safe and effective in reducing the risk of HIV transmission during sexual activity with an infected partner.

Journals Excerpts of Microbicide & HPV

About HPV
Human papillomavirus (HPV) is a virus from the papillomavirus family that is capable of infecting humans. Like all papillomaviruses, HPVs establish productive infections only in keratinocytes of the skin or mucous membranes.

While the majority of the known types of HPV cause no symptoms in most people, some types can cause warts (verrucae), while others can – in a minority of cases – lead to cancers of the cervix, vulva, vagina, penis, oropharynx and anus. Recently, HPV has been linked with an increased risk of cardiovascular disease.In addition, HPV 16 and 18 infections are strongly associated with an increased odds ratio of developing orophanyngeal cancer.

More than 30 to 40 types of HPV are typically transmitted through sexual contact and infect the anogenital region. Some sexually transmitted HPV types may cause genital warts. Persistent infection with "high-risk" HPV types — different from the ones that cause skin warts — may progress to precancerous lesions and invasive cancer. HPV infection is a cause of nearly all cases of cervical cancer. However, most infections with these types do not cause disease.

Microbicide & HPV
HIV-1, herpes simplex virus type 2 (HSV-2), and human papillomavirus (HPV), among other sexually transmitted infections, represent a major burden for global health. Initial insights into the mucosal transmission of these viral pathogens have raised optimism with regard to the rapid generation of protective vaccines. Nevertheless, setbacks for HIV-1 and HSV-2 vaccines have seriously challenged the initial enthusiasm.

Recently, two new vaccines that efficiently prevented HPV infection have renewed the hope that vaccinal prevention of viral mucosal sexually transmitted infections is possible. HIV-1 and HSV-2 differ from HPV, and each virus needs to be tackled with a distinct approach. However, vaccines are not the only possible answer. Topically applied agents (microbicides) are an attractive alternative in the prevention of HIV-1 and HSV-2 mucosal transmission. Progress in understanding the mechanisms of genital transmission of HIV-1 and HSV-2 is required for successful vaccine or microbicide candidates to emerge from current approaches.
(Vaccines and microbicides preventing HIV-1, HSV-2, and HPV mucosal transmission; Nikolic DS, Piguet V.)

Microbicide & STD

What Does Everyone Need to Know About STDs?

Sexually transmitted infections (STI), also previously referred to as sexually transmitted diseases (STD) and venereal diseases (VD), are illnesses that have a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex. While in the past, these illnesses have mostly been referred to as STDs or VD, in recent years the term sexually transmitted infections (STIs) has been preferred, as it has a broader range of meaning; a person may be infected, and may potentially infect others, without having a disease. Some STIs can also be transmitted via the use of IV drug needles after its use by an infected person, as well as through childbirth or breastfeeding. Sexually transmitted infections have been well known for hundreds of years.

Everyone, young or old, rich or poor, sexually active or not, needs to know a few important facts about sexually transmitted diseases. It’s particularly important that, if we are parents, we spend time throughout our children’s lives discussing these issues in an age-appropriate manner. The more educated our children and teens are about the facts about sexually transmitted diseases, the better the chance is that if they do decide to have sex they will know how to protect themselves from sexually transmitted diseases and infections, as well as HIV the virus that causes AIDS, and unplanned pregnancy.

Sexually transmitted diseases do not discriminate. You can be any age, race, religion, financially secure or insecure, any education level and hold any job from blue collar to CEO. The point is anyone who participates in sexual activity is at risk of contracting a sexually transmitted disease or infection.

It may not surprise you to know that the majority – two-thirds – of all sexually transmitted diseases occur in teenagers and young adults under the age of twenty-five years old. Even with all the education and resources available today, sadly, the number of cases of STDs continues to rise.

Some ways to reduce the chance of having sexual contact with a member of the infected pool, and thus of becoming part of that pool include:

- Stop having sex until you see a doctor and are treated.
- Follow your doctor's instructions for treatment.
- Use condoms and/or microbicide whenever you have sex, especially with new partners.
- Don't resume having sex unless your doctor says it's OK.
- Return to your doctor to get rechecked.
- Be sure your sex partner or partners also are treated.

Microbicide & Herpes (2)

Genital herpes is one of the most prevalent sexually transmitted infections worldwide and is the most common cause of genital ulcers. Despite increased public awareness and the initiation of efforts to prevent transmission, the prevalence of herpes simplex virus (HSV) type 2 continues to increase.

What makes HSV so difficult to control is that most sexual and perinatal transmission occurs during unrecognized or asymptomatic shedding. The impact of genital herpes as a public health threat is amplified because of its epidemiological synergy with HIV/AIDS. Thus, there is an urgent need for novel prophylactic methods, such as topical microbicides designed for genital application, to prevent both HSV and HIV transmission.

In summary, genital herpes is a critical global health priority because of its devastating impact on young adults and infants and its association with the HIV/AIDS epidemic. Topical microbicides that block transmission at the mucosal surface may provide a realistic method of intervention for worldwide distribution. Currently, there are several candidate drugs being advanced to clinical trials that block both HSV and HIV infection by inhibiting binding and entry in vitro.

Whether blockade of entry will be sufficient to prevent sexual transmission or whether a combination strategy targeting multiple steps in the viral life cycle will be required is not yet known. Importantly, before embarking on large-scale clinical trials, more extensive evaluation of candidate microbicides, including assessment of the impact on innate defences, is warranted. Assessment of the safety and mucosal response to microbicides should be accrued from several different models including cell and organ cultures, animal models and, most importantly, pilot clinical studies.

((Excerpt of)Topical microbicides for the prevention of genital herpes infection: Marla J. Keller, Ana Tuyama, Maria Josefina Carlucci and Betsy C. Herold)

A topical microbicide that silences two genes can safely protect against genital herpes infection for as long as one week, according to a joint study by researchers at the Albert Einstein College of Medicine of Yeshiva University and Harvard Medical School.

Microbicide & Herpes (1)

Excitement here over a microbicide that protects women against HIV grew when researchers reported that it also protects against herpes simplex virus-2 (HSV-2) infection.
The gel is not a contraceptive, but a microbicide. Microbicidal gels or creams are inserted into the vagina solely to prevent the spread of HIV and other sexually transmitted diseases. There are currently no such products on the market. Women who have herpes are at increased risk of contracting HIV, so diminishing the risk of getting herpes also diminishes the risk of HIV infection.
In a randomized controlled trial, the vaginal gel reduced women's risk of HIV infection by 39% compared with placebo, according to researchers.


A 2010 clinical trial found that microbicides -- vaginal gel spiked with antiretrovirals -- cut HIV transmission during sex by 39 percent. But researchers also found that microbicides reduced a woman's risk of herpes by a whopping 51 percent.

(Excerpts of) A Summary of Preclinical Topical Microbicide Vaginal Safety and Chlamydial Efficacy Evaluations in a Pigtailed Macaque Model

Patton, Dorothy L. PhD; Cosgrove Sweeney, Yvonne T. BA; Paul, Kathleen J. MPH

Background:
The development of topical microbicides represents a new and exciting field in the prevention of sexually transmitted diseases, and it is especially important that candidate products undergo rigorous preclinical safety and efficacy testing before advancing to clinical trials.

Methods:
We have developed a standardized protocol for preclinical vaginal safety and efficacy assessment of topical microbicide candidates in a nonhuman primate model. Over 7 years of funding under an NIH contract, we evaluated a total of 28 test compounds for vaginal safety (via colposcopy, vaginal pH, and microflora) and 9 compounds for efficacy against cervical chlamydial infection. We also outline the specific criteria used to determine which products should move into efficacy trials and which should be recommended for reformulation to the manufacturer.

Results:
Overall, we noted acceptable safety profiles for 24 of 28 candidate products. Common findings included a transient decrease in vaginal pH, petechiae, and mild erythema. Four products were associated with significant adverse colposcopic findings including blisters, epithelial abrasions, and friability; all 4 products were successfully reformulated and showed acceptable safety profiles at lower concentrations. No products showed complete protection against cervical chlamydial infection.

Conclusions:
The macaque preclinical safety and efficacy model is critical to maintaining the pace of topical microbicide development, which could ultimately offer a significant opportunity for intervention in the global HIV/AIDS epidemic.

Overall safety profiles were acceptable in 24 products. Microbiologic findings common to most products included stable populations of H2O2-producing lactobacilli and Viridans streptococci and transient decreases in anaerobic Gram-negative rods.

Microbicide Safety

The development of topical microbicides represents a new and exciting field in the prevention of sexually transmitted diseases, and it is especially important that candidate products undergo rigorous preclinical safety and efficacy testing before advancing to clinical trials.


The physico-chemical and biological properties of active pharmaceutical ingredients (APIs) and their formulations are the foundation of safe, efficacious and acceptable microbicides. Hence, the initial selection of the API and its primary formulation is crucial. Certain undesirable properties of an API can be compensated or masked by an appropriate formulation. However, there is a risk in proceeding with inadequate APIs or formulations, as they may fail later in development, costing more time and money. 

It is important to have a set of criteria that inform Go/No Go decisions prior to entering in clinical trials. This set of criteria is based on API and formulation parameters derived from a comprehensive evaluation of their in vitro P/C properties, drug release rates, specific activity, and cell and tissue toxicity, which in turn represent the base for animal studies focused on organ toxicity/safety, pharmacokinetics (PK), and pharmacodynamics (PD) and efficacy.

A solid preclinical foundation will help navigate clinical testing successfully, ultimately leading to a safe and effective microbicide. In addition to the more classical IND-enabling studies, new models, assays and biomarkers have been developed and adapted to the evaluation of genital and rectal microbicides.

Experience with previous microbicide candidates has led to the inclusion of assays evaluating the impact of genital environmental factors such as low pH, seminal plasma, CV secretions and microflora on microbicide safety and efficacy. Microbicide-induced inflammatory mediators and alteration of innate immunity have also been recently incorporated to the standard testing.

Looking for a Few Good Microbicides Candidates

Until recently, microbicide discovery was a by-product of the search for anti-HIV drugs. Early in the search for microbicides, for example, attention focused on detergents because of their ability to disrupt HIV’s coat. Most such easily testable candidates, however, failed as microbicides. Now that scientists know more about HIV’s life cycle,
they are beginning to identify multiple points at which the virus could be stopped.

Ideally, a microbicide should be:
• Colorless and odorless
• Inexpensive to manufacture and purchase
• Safe to use more than once a day and for long periods of time
• Effective against multiple STDs, including HIV/AIDS
• Fast-acting, long-lasting, and non-irritating
• Undetectable to either partner
• Available in contraceptive and non-contraceptive forms
• Available without a prescription

In theory, creating an effective topical microbicide should be easy. Simply identify chemicals that kill disease-causing organisms, blend the chemicals with an inert gel or foam, and place it in the vagina. Experience, however, has shown that the simple approach may not work.

The Research Pipeline 
Like a new drug or vaccine, topical microbicide development will follow a pathway—the research pipeline—from basic research to commercial production. The key points along the pipeline are basic research, product formulation and preclinical testing, and clinical testing.

Microbicide actions

Microbicides can act in various ways. Microbicides can be nonspecific, moderately specific or highly (exclusively) specific to HIV. The nonspecific and moderately specific agents are often active against a variety of sexually transmitted microorganisms (e.g., chlamydia and herpesvirus) and may have a contraceptive effect. The HIV-specific agents interact directly with one or several steps of the infection or replication cycle of HIV.

Nonspecific microbicides
The nonspecific microbicides consist of buffering agents and of detergents or surfactants that include nonionic, anionic or cationic compounds. The detergents destroy the viral envelope by solubilizing membrane proteins. However, this nonspecific mechanism of action may also disrupt the cell membranes of the vaginal and cervical epithelium and cause erosions and lesions, leading to an increased risk of HIV infection.

Moderately specific microbicides
Moderately specific microbicides mainly comprise  macromolecular linear anionic polymers. Linear polyanions are active against HIV, HSV and in some cases demonstrate inhibitory activity against human papillomavirus (HPV), Neisseria gonorrhoeae and Chlamydia trachomatis. They block viral entry into cells through electrostatic interactions with the viral envelope proteins and, in some cases, host cell receptors. The lack of potency of linear polyanions for HIV and the ability of semen to further abrogate anti-HIV activity, may in part explain the lack of in vivo efficacy of these microbicides. In addition, adherence to product use and transmission via anal receptive sex, which would not be prevented by a vaginally applied microbicide, are other considerations.

Highly specific anti-HIV agents
HIV-specific microbicides should preferentially block the viral infection cycle before the viral genome gets
incorporated in the target cells as proviral DNA.

Targeting viral entry seems the most promising method, preventing virus particles from entering its susceptible cells and, as shown or expected for most entry inhibitors, also preventing transmission of the virus from virus-infected cells to uninfected cells or transmission of dendritic cell-captured virus to lymphoid cells, or both.

The Future of Microbicide

Topical microbicides are a broad class of agents designed to block or kill infectious microorganisms directly at the site of transmission. With the AIDS pandemic continuing its unrelenting global march (40 million current infections, 14,000 new infections per day) driven largely by sexual transmission, microbicides have moved steadily toward the front line of preventative strategies.

Indeed, many candidate anti-HIV microbicides are currently under development, with several already in clinical trials. A battery of promising protein-based HIV inhibitors can potentially be developed, but they face serious challenges of high production costs and instability during transport and storage.

In a recent issue of PNAS, Rao et al. presented an intriguing version of a “live microbicide” approach whereby a commensal bacterium is engineered to secrete a potent anti-HIV peptide. When administered orally or as a rectal suppository, the bacteria would colonize the gut mucosa and secrete the peptide in situ, thereby providing protection in advance of exposure hopefully for days, weeks, or even months. This delivery mode would be highly advantageous over others requiring repeated topical application before each act of intercourse; also, the engineered bacteria would be relatively simple and inexpensive to manufacture, transport, and store.(An anti-HIV microbicide comes alive; Laurel A. Lagenaur and Edward A. Berger)

An antiretroviral microbicide gel can cut HIV infection in women by more than 50% if used consistently.
Most of the products tested previously as microbicides were either sulphated polysaccharides — which are intended to stop the virus from entering cells — or agents that prevent infection by killing either the virus or cells that carry it.

(Excerpt of) Potential Impact of Vaginal Microbicides on HIV Risk Among Women with Primary Heterosexual Partners

James M. McMahon, PhD, Associate Professor, Kathleen M. Morrow, PhD, Associate Professor, Margaret Weeks, PhD, Professor, Dianne Morrison-Beedy, PhD, RN, FNAP, WHAP, Professor and Dean, and Amanda Coyle, APRN, Senior Associate

Over the past 2 decades women have increasingly shouldered the burden of the global HIV pandemic (Joint United Nations Programme on HIV/AIDS [UNAIDS], 2004), with the majority of infected women acquiring HIV through sexual contact with a primary male partner (O’Leary, 2000). These trends are the result of multiple factors. Women may be biologically more susceptible to heterosexual transmission of HIV than men, especially via receptive anal intercourse (Boily et al., 2009; Mastro & Kitayaporn, 1998; Padian, Shiboski, & Jewell, 1991). 

In addition, gender-based social inequalities limit women’s options with regard to protective sexual behavior (Higgins, Hoffman, & Dworkin, 2010; Quinn & Overbaugh, 2005; Remien, Halkitis, O’Leary, Wolitski, & Gomez, 2005). Latex condoms, currently the only effective form of barrier protection against HIV, are under the control of men, who often are unwilling to use them, especially in the context of primary relationships (Conley & Collins, 2005).

Vaginal microbicides represent a female-initiated form of barrier and/or chemical protection that can potentially empower women with a means of self-protection. Vaginal microbicides are self-administered chemical compounds, most commonly in the form of a gel, that women can apply intravaginally prior to sexual intercourse to prevent or reduce HIV transmission. Modeling studies indicate that even a partially effective microbicide could have a major impact on the global HIV pandemic (Watts, 2002). 

About Personal Water Based Lubricant

Lubricant is a substance, typically fluid, that is used to reduce friction during sexual activity. Water-based lubricants are specifically those fluids or gels that are made from a base of water and typically a cellulose solution. A water-based lubricant is water soluble and can therefore be fairly easily washed off. The earliest and still most prevalent forms of personal lubricants are water-based, though newer forms of oil-based and natural lubricants have come onto the market.

Because they are water-based, such lubricants can have a tendency to dry out during use. This can be remedied to some extent by applying more of the lubricant or by applying a small amount of water to the area. A water-based lubricant will dry on its own and be absorbed into the skin or dissolve after use, leaving only the residue of the other ingredients. Because a water-based lubricant can dry out it is usually best to reapply during use to prevent a buildup of friction that can cause injury such as blistering or skin irritation.

Microbicides and women

Microbicides are substances capable of reducing the transmission of HIV and other sexually transmitted pathogens when applied vaginally.Evidence from many settings strongly suggests that many women will find microbicides easier to use than condoms and that they can be used when condom use is not possible. This has raised the concern that women might abandon condoms in favour of microbicides. Indeed, the fear of 'condom migration' has been a major barrier to the widespread endorsement of microbicides as a potential method of HIV prevention.

Despite such high HIV-efficacy, there is substantial evidence that in many settings levels of consistent condom use is low, especially within primary partnerships. Studies show that even after directed intervention, the percentage of couples that achieve consistent condom use seldom exceeds 20-30%, except where individuals know that one partner is HIV infected. Success in increasing the consistency of condom use has been greatest among sex workers and other vulnerable groups, but even here, many sex workers do not use condoms consistently with their non-commercial, primary partners.

Even when condoms are used consistently they may be used incorrectly. The immense gap between the numbers requiring protection and those using condoms consistently and correctly could potentially be filled by microbicides.

With AIDS vaccine efforts at an impasse, microbicides -- virus-blocking gels inserted into the vagina before sexual intercourse -- have risen from their own string of setbacks to once again offer hope of preventing HIV infections, at least in women.

Identifying a microbicide that works even partially could have a huge effect. Almost half of the more than 33 million people living with HIV worldwide are women; in sub-Saharan Africa, the figure is 60%.Abstinence and condoms have been the only proven ways to prevent or reduce the spread of HIV among adults. Circumcision lowers the risk for men, and already-existing AIDS drugs are used prophylactically to reduce mother-to-child transmission during birth or breast-feeding.

(The Excerpt of) Potential Impact of Vaginal Microbicides on HIV Risk Among Women with Primary Heterosexual Partners

James M. McMahon, PhD, Associate Professor, Kathleen M. Morrow, PhD, Associate Professor, Margaret Weeks, PhD, Professor, Dianne Morrison-Beedy, PhD, RN, FNAP, WHAP, Professor and Dean, and Amanda Coyle, APRN, Senior Associate

Over the past 2 decades women have increasingly shouldered the burden of the global HIV pandemic (Joint United Nations Programme on HIV/AIDS [UNAIDS], 2004), with the majority of infected women acquiring HIV through sexual contact with a primary male partner (O’Leary, 2000). These trends are the result of multiple factors. Women may be biologically more susceptible to heterosexual transmission of HIV than men, especially via receptive anal intercourse (Boily et al., 2009; Mastro & Kitayaporn, 1998; Padian, Shiboski, & Jewell, 1991). 

In addition, gender-based social inequalities limit women’s options with regard to protective sexual behavior (Higgins, Hoffman, & Dworkin, 2010; Quinn & Overbaugh, 2005; Remien, Halkitis, O’Leary, Wolitski, & Gomez, 2005). Latex condoms, currently the only effective form of barrier protection against HIV, are under the control of men, who often are unwilling to use them, especially in the context of primary relationships (Conley & Collins, 2005).

Vaginal microbicides represent a female-initiated form of barrier and/or chemical protection that can potentially empower women with a means of self-protection. Vaginal microbicides are self-administered chemical compounds, most commonly in the form of a gel, that women can apply intravaginally prior to sexual intercourse to prevent or reduce HIV transmission. Modeling studies indicate that even a partially effective microbicide could have a major impact on the global HIV pandemic (Watts, 2002). 

While it is anticipated that the first generation of vaginalmicrobicides will be less effective at preventing HIV than latex condoms, the enormous potential of this new technology lies in its enhanced acceptability and usability by women. As our experience with the female condom has demonstrated, the importance of the acceptability of any new HIV prevention technology cannot be overstated (Kaler, 2004). It is therefore critically important that the public health sector in the United States prepare for the introduction of commercially available vaginal microbicides (Van de Wijgert & Coggins, 2002). While many American women have expressed a keen interest in vaginal microbicides (Darroch & Frost, 1999), the issues surrounding their acceptability and preference in relation to condom use are complex and have not received adequate attention. One complexity involves the potential reduction of condom use that might result from the introduction and adoption of microbicides.

Things to Consider Before You Buy Vaginal Lubricants

Vaginal lubricants are available in a variety of products containing various ingredients.
It's important for women to read the label of a vaginal lubricant and buy only water-based vaginal lubricants.
Petroleum-based lubricants can harbor bacteria in the vagina and lead to infection, as well as cause damage to latex condoms rendering them ineffective against unplanned pregnancy and STDs.

Many times women believe that vaginal lubricants or moisturizers are only for women going through menopause and experiencing vaginal dryness; however, normal estrogen fluctuations often cause vaginal dryness creating the need for extra vaginal lubrication.

Vaginal dryness often occurs during:
• the menstrual cycle,
• pregnancy,
• childbirth,
• nursing,
• times of emotional stress,
• and when using a condom.

The Best Type of Vaginal Lubricant
There are several different types of vaginal lubricants available over-the-counter, as well as estrogen-based creams available by prescription.
Vaginal lubricants come in tubes, bottles, and as vaginal suppositories.
Which product works best for your situation is mostly a matter of personal preference.

Gardnerella & Candidiasis (3)

CAUSES OF CANDIDA PROLIFERATION 

- A diet rich in sugar, white flour, and acidic foods.
These are candida's favourite nutrition.

- Pregnancy.
The high levels of progesterone for nine months may cause current colonies of candida to grow in size. Specifically if the mother has lived with a diet rich in sugar and white flour before and during her pregnancy. (Please note. Candida can be passed from the mother to the baby during birth. And candida can cause much discomfort in a baby. Furthermore, baby formulas could be high in sugar and feed the baby's candida.)

- Contraceptive pills.
These pills are very high in progesterone, and because a woman typically takes pills longer periods, this provides a happy environment for the candida to thrive.

- Antibiotics (including antibiotics in commercially-raised beef, chicken and fish).
Antibiotics kills off both bad and good bacteria. The good bacteria it kills off in our intestines is the lactobacillus acidophilus. It lives side by side with the candida albicans, and contributes to the health of our digestive system. However, when a round of antibiotics kills the lactobacilli, that leaves our intestines in an acidic environment (candida loves acidic), which then allows the spread of the candida colony into the space left empty by the dead lactobacilli.

Gardnerella & Candidiasis (2)

What You Should Know About Candidiasis

Candidiasis, (commonly known by other names thrush, yeast infection, fungal infection) like diabetes, has been dubbed a 20th-century disease, proclaimed widespread and charged with causing complaints such as allergies, migraines, mental disorientation, bloating, skin complaints, and at their worse, organ failure and cancer.

Candidiasis, or yeast infection, is a stealthy attacker, in that it mimics symptoms of other illnesses and thus go unidentified as candida. That is the reason candida population can bloom in our bodies unchecked until it has proliferated well into every part of our system (systemic candida).

The problem with mainstream medical professionals is that a large number of them do not believe in the dangers posed by candida. Instead they treat the symptoms that manifest clearly – allergies, coughs, chronic bronchitis, and such, without knowing that the medications prescribed may actually make the yeast infection worse.

Take allergies for example. Allergies have mystified health practitioners for decades. And yet, although the candida-allergy connection had been discovered and confirmed by biological technologists and natural health therapists since the 1970s, it is yet to be a recognised branch in the study of conventional medicine. Research studies show that to control yeast infections would ultimately cure most allergies, because an uncontrolled growth of candida in our blood system is a major cause of allergic reactions to chemicals in our food, air and water.

Candida yeast are a normal component of healthy flora existing in our bodies. They are tiny, microscopic plants that love warm, dark and moist environment, and so seek places like the intestines, the walls of the vagina, and when systemic (all over our body) the blood vessel linings and mucous membranes of our organs. Because they are plants, candida yeast have roots, stem and foliage. They sink their roots into the mucous membranes of the body, which, to candida, are fertile soil.

Gardnerella & Candidiasis (1)

When women are experiencing issues with their reproductive tract it's important to determine what the problem is and the way to treat it best.
In the case of Gardneralla and vaginal Candidiasis it can be confusing for women to know which one of these infections they might have.

This is a problem since Gardnerella and Candidiasis are treated in entirely different ways.

If a woman thinks she has Candidiasis and then goes and gets an over the counter treatment for yeast infections, but at the same time has Gardnerella, then she is not only wasting her money, but also not treating the infection.
Infections left untreated only get worse.

Gardnerella is caused by bacteria infecting the female reproductive tract and it is referred to as bacterial vaginosis.

This overgrowth of bacteria can be brought on by having unprotected sexual intercourse with a partner who is infected with the Gardnerella vaginalis bacteria, however, it has been contracted in some cases non-sexually too.

Women with Gardnerella will have a grey or yellowish discharge when infected and it will produce a strong fishy odor especially when washed with alkaline based soaps.

Women will experience little to no irritation when infected with Gardnerella and the noticably symptom is the odor.

A doctor will prescribe an antibiotic to treat the infection and sexual partners should also be treated.

Douching can help with the odor, but will not treat the infection.


Vaginal Candidiasis

Candidiasis, on the other hand is caused by the fungus Candida albicans and occurs when there is an overgrowth of the yeast cells in the vagina as a result of antibiotics, weakened immune systems, poor diet, or sexual transmission.

Qualities a Microbicide Should Have

A Microbicide should:

-applicable several hours prior to intercourse
-not messy or "leaky"
-able to be applied easily and evenly around the vagina as well as cervix
-long-acting
-look, smell and taste fine
-able to avoid infection with no disrupting or irritating the delicate tissues
-bioadhesive (able to develop protective barrier against STD pathogens)
-protective against a variety of STDs
-acid-buffering (maintains regular acidity [pH] of vagina in presence of sperm)
-protective of natural vaginal environment ("friendly flora"), possibly even improving natural vaginal defense mechanisms

Some of the Microbicide's ingredients

These are some of the microbicide's ingredients:

Benzalkonium Chloride (Bzk)
Benzalkonium chloride, also known as alkyldimethylbenzylammonium chloride and ADBAC, is a mixture of alkylbenzyldimethylammonium chlorides of various even-numbered alkyl chain lengths. This product is a nitrogenous cationic surface-acting agent belonging to the quaternary ammonium group. It has three main categories of use; as a biocide, a cationic surfactant and phase transfer agent in the chemical industry.

BZK demonstrates potent in vitro activity against the majority of microorganisms causing sexually transmitted infectious diseases, including those acting as major genital cofactors of HIV transmission and associated with high morbidity or mortality. (In vitro inactivation of Chlamydia trachomatis and of a panel of DNA (HSV-2, CMV, adenovirus, BK virus) and RNA (RSV, enterovirus) viruses by the spermicide benzalkonium chloride
Laurent B-leca,b,*,  Carol Tevi-Benissana,  Anne Bianchic,  Sylvie Cotignya, Maria Beumont-Mauvielc,  Ali Si-Mohameda and  Jean-Elie Malkinc)

Xylitol
Xylitol is an organic compound with the formula (CHOH)3(CH2OH)2.Xylitol has no known toxicity in humans.

Xylitol is a sugar alcohol sweetener used as a naturally occurring sugar substitute. It is found in the fibers of many fruits and vegetables, and can be extracted from various berries, oats, and mushrooms, as well as fibrous material such as corn husks and sugar cane bagasse. Xylitol is roughly as sweet as sucrose with only two-thirds the food energy.

Microbicide Q & A (3)

How would an HIV microbicide function?
An HIV microbicide could work in 5 different ways:
- Eliminating or inactivating pathogens.
A microbicide could inhibit HIV infection by breaking down the surface of the virus or pathogen.
- Create physical barriers. Gels or creams could offer a physical barrier between pathogens or viruses, and susceptible cells in the epithelium (cell wall) of the vagina or rectum.
- Strengthening the body's natural protection.
The body has numerous naturally sourced defense system that a microbicide might be able to supplement or enhance. For example, lactobacillus is a naturally occurring, "good" bacteria that helps protect the vagina by keeping its acidic environment. This natural acidity helps foster an inhospitable environment for a lot of pathogens, including HIV. A microbicide that supports the lactobacilli in carrying out this function might inhibit infection by HIV or STDs.
- Inhibiting viral entry.
A microbicide could inhibit viral or bacterial infection by interfering with the binding of viral proteins to cellular receptors. For example, infection with the HIV virus happens through binding of gp120 (on the outside of the virus) to receptors on a cell's membrane. A potential microbicide might interrupt this process by binding to receptors ahead of time, thus blocking the sites and preventing HIV attachment to the cell.
- Suppressing viral replication. Designed as gels or creams, anti-HIV medications that are already FDA-approved and available might be able to reduce replication of HIV in the vagina or rectum during sexual intercourse.

Microbicide Q & A (2)

Who is working on microbicide research and development?
Virtually all microbicides research to date has been conducted by non-profit and academic institutions or small biotech companies. Research is financed by charitable foundations along with government grants. These public funds also support basic science, social and behavioural research, and clinical study infrastructure that contribute to microbicides research and development. Large pharmaceutical companies have not invested significantly in this area, this is mostly because their income would be minimal.

Why do we need microbicides if we will finally have an HIV-vaccine?
No method or technology will "solve" the AIDS pandemic. We must implement all existing prevention methods --such as behavior change, voluntary counselling and testing, STI diagnosis and treatment, extensive access to male and female condoms, and anti-retroviral interventions-- as well as extend our collection of resources and technologies. Microbicides will probably be accessible and available sooner than an HIV-vaccine. Even after a safe and effective vaccine is discovered, vaccines and microbicides will have different, complementary roles to play in an integrated, multi-faceted global HIV prevention strategy.

Would a microbicide also protect the male partners of HIV positive women?
Lots of candidate microbicides currently being examined are widely anti-microbial and may provide protection against a variety of sexually transmitted infections, including HIV.  By neutralising pathogens in both semen and vaginal secretions, these products will give bi-directional protection; that is, will help protect men and partners. This will give HIV positive people a way of minimizing their partner's risk of HIV exposure during intercourse --as well a way of reducing their own risk of re-infection.
Microbicides will also provide valuable back-up protection to couples who use them with condoms. If the condom slips or breaks, the microbicides can provide both partners added protection from possible infection.

Why would a man want to use a microbicide instead of a condom?
Lots of men dislike using male condoms, regardless that they are excellent barriers against infection and unintended pregnancy. Objections include perceived decrease in pleasure, difficult maintaining an erection, interruption of spontaneity and decrease of the intimacy associated with skin to skin contact. Even before the spread of HIV/AIDS resulted in higher concern about STIs, these factors influenced men's attitude towards condoms. Largely, they account for the popularity of non-condom methods of contraception.
However, non-condom methods of STIs prevention do not yet {exist|be found}. Even when microbicides reach the market, it is unlikely that they will meet the efficacy of male and female condoms for HIV prevention. Logically, it is advisable to keep a virus from coming into contact with one's body than it is to try to eliminate it once it is there.
But, for men and women who don't use condoms regularly, microbicides will offer an essential risk reduction option. Using even a partially effective microbicide will provide significantly more protection than using nothing at all.

Microbicide Q & A (1)

What is a microbicide?
A microbicide is a compound that eliminates micro-organisms.

What does a microbicide do?
Topical microbicides, applied to lining of body cavities, work as chemical barriers to avoid the spread of Sexually Transmitted Diseases (STDs).
An HIV microbicide provides the potential for a protection choice that both women and men could effortlessly control, with or without the consent or knowledge of their sexual partner.

What forms can a microbicide come in?
A microbicide could be produced in various forms including gels, creams, suppositories, films, or in combination with a sexual lubricant.

Will different HIV microbicides be necessary for vaginal and rectal use?
Probably.
Different microbicides will be necessary for the vagina and for the rectum because of differences in their physical structure and properties.
An effective rectal microbicide must take into consideration that HIV is more easily transmitted during anal rather than vaginal intercourse.

Will a microbicide cure AIDS?
No, a microbicide is not a remedy for those already infected with HIV.
Instead, it would be an HIV prevention option, impeding (or halting) the transmission of HIV.